Presbyopia is a health condition where the eye exhibits a progressively diminished ability to focus on near field objects with age. Presbyopia's exact mechanisms are not known with certainty. The research evidence supports a loss of elasticity of the crystalline lens. In addition changes in the curvature of the lens from continual growth and loss of power of the ciliary muscles (the muscles that bend and straighten the lens) have also been postulated as its cause.
Standard of care of presbyopia is the use of reading glasses. Other approaches have been utilized including accommodative intra-ocular lenses (IOLs), multifocal IOLs, multifocal Lasik and other approaches involving optical correction.
US 2010/0076417 discussed the concept of removing or altering the crystalline lens with ultrashort laser pulses. Others (e.g. U.S. Pat. No. 6,824,540, U.S. Pat. No. 6,745,775, US 2006/0253111, US 2008/0065055 and US 2008/0097418) discussed the concept of removing scleral tissue to treat presbyopia. The treatment of presbyopia taught in these references pertains to making channels in the sclera by tissue ablation on the order of magnitude of 400-700 microns and specifically through over 60% of the scleral thickness.
Some of the main issues with these scleral treatment approaches, for example, are cosmetic discoloration of the sclera after treatments, lack of customization of the procedures to the patient's degree of accommodation or response to treatment, and the fact that these are invasive procedures done in the operating room environment.
Accordingly there is a need in the art to overcome at least some of the issues and develop new techniques for the treatment of presbyopia.